Dioxin Poisoning

London (NYT)  Tests done at a hospital in Vienna, Austria, confirmed that Viktor A. Yushchenko, the Ukrainian opposition candidate, had been poisoned with dioxin, doctors there said Saturday, providing an explanation for a broad array of painful and disfiguring conditions that plagued him during the past three months of the presidential campaign.

There was no doubt that Yushchenko's disease has been caused by a case of poisoning by dioxin, Dr. Michael Zimpfer, president of the Rudolfinerhaus Hospital said at a news conference on Saturday. He said that Yushchenko's blood dioxin level was more than 1,000 times the upper limits of normal and that his initial severe abdominal pain suggested that he had eaten the poison.

We have proved the source of his problem, and we clearly suspect third party involvement, Zimpfer said in a subsequent interview. But he said law-enforcement authorities would have to determine how the poisoning occurred.

Yushchenko has long insisted that he was poisoned, and on Friday, he repeated his suspicions of the motive, saying: It is my growing conviction that what happened to me was an act of political reprisal against a politician in opposition. The aim, naturally, was to kill me.

His opponents have ridiculed such claims, saying that the once telegenic candidate had been stricken by bad sushi or too much drink.

A spokeswoman for Yushchenko, Irina Gerashchenko, said in a telephone interview that the diagnosis compelled prosecutors to reopen a criminal investigation into his poisoning. It means that an attempt on the life of a presidential candidate was made, she said.

Yelena A. Grimnitskaya, a spokeswoman for the departing president, Leonid D. Kuchma, said in a telephone interview that Kuchma would have no immediate comment.

Yushchenko's illness was largely overshadowed by the drama of the disputed presidential runoff, and its effect on the new campaign remains unclear.

On Dec. 5, the country's Supreme Court threw out the results of last month's vote declaring Prime Minister Viktor F. Yanukovich the winner and ordered a new runoff for Dec. 26, only two weeks away.

Last week, Kuchma and parliamentary leaders, including Yushchenko, reached an agreement on changes to the country's political system and election laws. That defused a crisis that had brought tens of thousands of protesters out on the street, paralyzed the government and harmed the economy.

That agreement also appeared to defuse, at least outwardly, the personal tensions between Yushchenko and Kuchma, whose government presumably includes the authorities that Yushchenko and his supporters have accused of being responsible for his illness.

Yushchenko has always been vague on the topic of who tried to poison him. He fell ill after having dinner on Sept. 5 with the head of Ukraine's successor to the KGB, Ihor P. Smeshko.

Smeshko acknowledged meeting Yushchenko but dismissed the notion that he might have been involved in poisoning him, as many of Yushchenko's supporters say they suspect.

During the earlier years of the Cold War, the KGB and the Eastern European intelligence services in some cases used poison against political enemies.

One of the most famous cases involved the poison ricin. The Bulgarian dissident, Georgi I. Markov, was killed in 1978 at a London bus stop by the Bulgarian secret service, apparently to silence his broadcasts on the British Broadcasting Corp. A platinum pellet injected into Markov's leg with a spring-loaded umbrella contained a dose of ricin that killed him after three days of intense fever and vomiting.

Dioxin, a waste product of various industrial chemical processes, is a highly toxic chemical that remains in the body for years after exposure, so doctors were able to test their patient Friday, long after the near-fatal poisoning occurred. Initially the poison often produces severe abdominal pains, nausea and vomiting  and, in the long term, very high doses can produce the kind of skin cysts and discoloration that have disfigured Yushchenko.

Such cysts can persist for years after the initial dose, as do several other more subtle medical effects. Dioxin causes a strong predisposition toward developing cancer later in life and can also affect the body's fat metabolism. But none of that would affect Yushchenko's political aspirations today. If you survive the initial attempt, you can do all right, Zimpfer said. He is perfect condition, in perfect mental shape.

Gerashchenko said Yushchenko would return to Ukraine  and to the campaign trail  on Sunday or Monday. No further medical treatment has been ordered for him.

Ukraine's prosecutor general, Gennady A. Vasiliyev, had conducted an investigation but closed it, saying there was no evidence of poisoning. Vasiliyev became a casualty of last week's agreement between Kuchma and Yushchenko, submitting his resignation to meet one of the opposition's demands. On Friday, Kuchma replaced him with a former prosecutor general, Svyatoslav M. Piskun, though his appointment only remains effective until a new president is elected.

The parliament, or Supreme Rada, also conducted an inquiry into Yushchenko's illness in the heated weeks before the first round of voting on Oct. 31. But that inquiry concluded that while Yushchenko might have been poisoned, he had no basis for accusing the authorities.

An extremely unusual cause of poisoning, dioxin exposure most often comes from industrial accidents where it is inhaled or absorbed through the skin. Yushchenko had not been previously tested for dioxin, partly because it is so rare and partly because the telltale facial cysts were not prominent during two prior hospital stays, in September and October.

It is very difficult to detect, the doctor said. It doesn't show up in the normal 360 panel.

Doctors in Vienna declined to speculate on exactly how Yushchenko was poisoned.

We weren't there and we will have to leave that to the legal authorities to decide, he said. Some supporters of Yushchenko say that he first fell ill on the morning after he dined with the head of Ukrainian State Security. His wife, a Ukrainian-American, has said that when they kissed, she could smell the poison on this breath.

Yushchenko was admitted to Rudolfinerhaus in September, suffering from severe abdominal pain. His stomach and intestines were covered with small ulcers, and his blood tests showed numerous abnormalities of his liver and spleen. From the start, he had small skin rashes, but these were not suggestive of poisoning at the time.

After five days and only partially recovered, Yushchenko headed back to Kiev to campaign. Just 10 days later, he was suddenly felled by back pain that was so severe he had to be re-admitted to the hospital, where he required huge doses of morphine. The only way he was able to return to the campaign was when he opted to allow doctors to insert a pain killing tube through his back into his upper spine, a risky but effective treatment.

Yushchenko returned to Rudolfinerhaus on Friday for further testing, after his skin cysts worsened, and doctors became more suspicious that dioxin was the cause.

Steven Lee Myers contributed reporting from Moscow for this article, and James Risen from Washington.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Yushchenko wants poisoning probeDec. 13, 2004
Ukraine opposition leader Viktor Yushchenko has called for a "serious investigation" following the upcoming election, after doctors said dioxin poisoning caused his disfiguring illness. As he left the Vienna, Austria clinic Sunday where doctors made the diagnosis, Yushchenko told reporters he did not want to talk about the poisoning until after the December 26 rerun of the presidential runoff. "I don''t want this factor to influence the election in some way -- either as a plus or a minus," The Associated Press quoted him as saying in Russian. "This question will require a great deal of time and serious investigation. Let us do it after the election -- today is not the moment." Wearing his trademark orange campaign scarf, he flashed a V-sign out of the window of his car before he was driven from Vienna's elite Rudolphinerhaus clinic. At an earlier news conference at the clinic, Yushchenko did not address the doctors'' diagnosis and did not take questions. He was accompanied by his doctors and his U.S.-born wife, Kateryna Chumachenko, who translated her husband's comments into English. Yushchenko said he was "happy to be alive in this world today" and thanked the doctors and their team, who announced their findings Saturday. The doctors said they suspect a "third party" administered the poison in September, possibly by putting it in Yushchenko's soup. (Full story) Yushchenko has accused Ukrainian authorities of poisoning him -- an allegation which they have denied. Yushchenko said support for him in Ukraine -- where hundreds of thousands have protested controversial election results -- was comparable to the groundswell that led to the fall of the Berlin Wall. "We haven''t seen anything like that in Ukraine for the past 100 years," he said. "I think it would be appropriate to compare this to the fall of the Soviet Union or the fall of the Berlin Wall." Yushchenko said the outpouring showed the world "a different nation, a different country." "The regime that was living for 14 years in Ukraine is now living its last days," he said. "Old people, young people -- they were defending not Yushchenko, but the kind of Ukraine they wanted to see." Of the medical team at the Vienna clinic, Yushchenko said, "I am very happy to be alive in this world today, and I thank these people for this." In September, the 50-year-old presidential candidate fell ill a day after attending a reception and dinner with Ukrainian security services leaders. It is believed that Yushchenko, who mostly drank liquids at the event, is the only one who became sick. Yushchenko went to the Austrian hospital for treatment five days later. He suffered from a series of symptoms, including back pain, acute pancreatitis and nerve paralysis on the left side of his face. Aides said if he had remained in Ukraine he could have died. On Saturday, Russia's Interfax news agency reported that Ukraine's prosecutor-general was reopening an investigation into Yushchenko's illness following the doctors'' report. A previous investigation, by another prosecutor who has since been fired, had been looking into the possibility that biological agents were used against Yushchenko. In Washington, U.S. State Department spokeswoman Joanne Moore said officials had seen the doctors'' report and "are deeply concerned about these findings." "We urge Ukrainian authorities to investigate this matter," she said. However, Yushchenko's political rivals dismissed the diagnosis, saying the reports were part of last-minute campaigning. Campaigners for his opponent, Prime Minister Viktor Yanukovych, rushed to reject suggestions their candidate could have been involved. There is "no logic in such an accusation," The Associated Press quoted Yanukovych's campaign manager, Taras Chornovyl, as saying. Yanukovych's former representative on the Central Election Commission, Stepan Havrysh, questioned the doctors'' statement, saying that while he felt sorry for Yushchenko, "I''m afraid, two weeks before the vote, it's all political." Havrysh called the issue "a painful theme for Ukrainian democracy." Yushchenko faces Yanukovych on December 26 in a repeat of last month's vote. Yanukovych was declared the official winner, but the Supreme Court threw out the results because of voting irregularities. In Vienna Saturday, the director of the Rudolphinerhaus clinic said there was no doubt Yushchenko had ingested dioxin, but he could not say whether the poisoning was intentional. "What we can say at this point is that this concentration constitutes an amount which is 1,000 times above the normal levels that you would find in blood or [skin] tissue," said Dr. Michael Zimpfer, who noted that doctors at his and other European clinics had conducted tests during the past 24 hours. According to the Encyclopedia Britannica, dioxin refers to a group of contaminants that are the byproducts of herbicides such as Agent Orange and is linked to a variety of diseases that especially affect residents of Vietnam and veterans of the war there. Dioxin dissolves in oil and gets into body fat, according to Britannica. Zimpfer said: "We can state that there has been an oral intake. "It would be quite easy to administer this amount in a soup that contains cream, and I am saying cream because of the issue of fat solubility." The dioxin caused bloating and pockmarks to Yushchenko's face, a disease called chloracne, and prompted accusations that opponents of the candidate tried to assassinate him -- an allegation they have denied. A doctor at Saturday's news conference said the changes in Yushchenko's face will remain for a long time. More treatment will be needed to determine whether his face can be restored to the way it had looked. Yushchenko had long been known for his good looks. Saturday, Yushchenko's wife said she was convinced her husband was the victim of an assassination attempt. "I knew from the very beginning he was poisoned," Chumachenko told AP as she arrived at the clinic.